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Splints

This document discusses periodontal splints, including their history, definitions, classifications, objectives, indications, and advantages/disadvantages. It describes different types of splints according to period of stabilization (temporary, provisional, permanent), material used, and location on teeth (intracoronal, extracoronal). Common splinting techniques for anterior and posterior teeth are outlined. The principles of splinting emphasize including sufficient healthy teeth and splinting around the dental arch.

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Prathik Rai
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65 views

Splints

This document discusses periodontal splints, including their history, definitions, classifications, objectives, indications, and advantages/disadvantages. It describes different types of splints according to period of stabilization (temporary, provisional, permanent), material used, and location on teeth (intracoronal, extracoronal). Common splinting techniques for anterior and posterior teeth are outlined. The principles of splinting emphasize including sufficient healthy teeth and splinting around the dental arch.

Uploaded by

Prathik Rai
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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PERIODONTAL

SPLINTS
Historical Perspective
 Phoenix mandible (500 B.C) - Goldwire for
splinting weakened anterior teeth
 Obin & Arvins (1951) - Self curing internal splint
 Cross (1954 ) –Continuous amalgam splint
 Harrington (1957) – Cemented stainless steel
wire
 Lyod & Baer (1959 ), Ward & Weinberg ( 1961 ) –
Plastic matrix or wire reinforcement
Definition
 Splint is defined as a rigid or flexible device
that maintains in position, a displaced or
movable part, also used to keep in place
and protect an injured part

 Splinting in dentistry means -The joining of


two or more teeth into a rigid unit by means
of fixed or removable restorations/devices
CLASSIFICATION
 According to the period of stabilization

 According to the type of material

 According to the location on the tooth


According to the period of stabilization

 A. Temporary Stabilization
Worn for less than 6 months

Removable Fixed
Occlusal splint with wire
Hawley with splinting arch wire

Intra Coronal Extra Coronal

Amalgam Stainless steel wire with resins


Amalgam & wire Wire & resin with acid etching
Amalgam , wire & resin Enamel etching & Composite resin
Composite, wire & resin Ortho soldered bands
Brackets & wire
 B. Provisional Stabilization
Worn for months to several years

Egs; Acrylic splints, Metal bands


 C. Permanent Stabilization
Used Indefinitely

Removable/Fixed Extra/Intra Coronal

Full or partial veneer crowns soldered together Inlay/Onlay soldered together


According to the Type of Material

 Bonded composite resin button splint


 Braided wire splint
 A- Splints
According to the location on the tooth

Intra Coronal Extra Coronal

Composite resin with wire Tooth bonded plastic


Inlays Night guard
Nylon wire Welded bands
OBJECTIVES OF SPLINTING

 To Provide rest

 To Redirect forces

 To redistribute forces

 To preserve arch integrity

 Restoration of functional stability

 Psychologic well being

 To stabilize mobile teeth during surgical, especially regenerative therapy

 To prevent the eruption of unopposed teeth


INDICATIONS
 To stabilize moderate to advanced tooth mobility that cannot be reduced by
other means and which has not responded to occlusal adjustment and
periodontal therapy

 Stabilize teeth with secondary occlusal trauma

 To stabilize increased tooth mobility when it interferes with normal


masticatory function

 Facilitate scaling and surgical procedures

 Stabilize teeth after orthodontic movement

 Stabilize teeth after acute dental trauma. e.g. subluxation ,avulsion etc

 To prevent tipping and drifting of teeth

 To prevent extrusion of unopposed teeth


CONTRA INDICATIONS
 Moderate to severe tooth mobility in the presence of periodontal
inflammation and/ primary occlusal trauma

 Insufficient number of firm / sufficiently firm teeth to stabilize


mobile teeth

 Prior occlusal adjustment has not been done on teeth with occlusal
trauma or occlusal interference

 Patient not maintaining oral hygiene

 When the sole objective of splinting is to reduce tooth mobility


following the removal of the splint
 SPLINTEE: Tooth that needs support

 SPLINTER: Adjacent teeth that provide


support
SPLINTING FOR ANTERIOR TEETH

 Direct bonding system

 Intracoronal wire & Acrylic resin splint


( “A” Splint)

 Variation of “A” Splint


Direct Bonding system
Intracoronal wire & Acrylic resin splint ( “A” splint)
Variation of “A” Splint
SPLINTING FOR POSTERIOR TEETH

 Intracoronal amalgam wire splints

 Bite (Night) Guard

 Rigid Occlusal Splint

 Composite Splints
Principles of Splinting

1. Inclusion of sufficient number of healthy


teeth

2. Splint around the arch

3. Coronoplasty may be performed

4. The splint should be fabricated in such a


way as to facilitate proper plaque control
ADVANTAGES OF SPLINTING

 May establish final stability and comfort for patient with


occlusal trauma

 Helpful to decrease mobility and accelerate healing


following acute trauma to the teeth

 Allows remodelling of alveolar bone and periodontal


ligament for orthodontically, splinted teeth

 Helpful in decreasing mobility thereby favouring


regenerative therapy

 Distributes occlusal forces over a wider area


DISADVANTAGES OF SPLINTING

 Hygienic

 Mechanical

 Biological
Hygienic
 All the splints hamper patient’s self care. Accumulation of plaque at
the splinted margins can lead to further periodontal breakdown in a
patient with already compromised periodontal support

Mechanical
 Number of studies have shown that splinting does not actually
reduce tooth mobility after the splint is removed. Tooth mobility is the
same as that can be achieved with SRP, Curettage & occlusal
adjustments
 The splint being rigid acts as a lever with uneven distribution of
forces. If one tooth of the splint is in traumatic occlusion, it can injure
the periodontium of all the teeth within the splint

Biological
 Development of caries is an unavoidable risk. It requires excellent
maintenance by the patient.

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